Effects of exercise on muscle fatigability in COPD: a systematic review and meta-analysis
Abstract
This systematic review aims to summarise the impact of exercise training on peripheral muscle fatigability in people with COPD, addressing different assessment methods and exercise interventions (i.e. endurance, resistance and combined training).PubMed, CENTRAL, CINAHL and PEDro databases and trial registers were searched from inception to September 2024. We identified randomised and nonrandomised trials assessing pre-to-post-training changes in muscle fatigue resistance, assessed as a reduction in volitional or non-volitional measures of muscle strength or muscle total work output during standardised fatiguing protocols. The Cochrane Risk of Bias 2 (RoB 2) and Risk of Bias in Non-randomized Studies - of Interventions (ROBIN-I) tools were used for assessing risk of bias in randomised controlled trials and nonrandomised studies of interventions, respectively, and meta-analyses were performed.A total of 20 studies (574 participants from 14 randomised controlled trials and 217 from six nonrandomised studies of interventions) were included. Overall, combined endurance and resistance training appeared to improve muscle fatigue resistance. While results varied by study design, type of training and fatiguing protocols, similar improvements were observed in quadriceps fatigue resistance regardless of the assessment method. In contrast, no significant improvements were observed in the fatigue resistance of the arm muscles. However, the presence of moderate to high risk of bias in…
How strong is the evidence?
Evidence Hub reads this as a meta-analysis, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid. Reported size: 574 participants or records.
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